BMC Cardiovascular Disorders最新文献

{"title":"Adipokine isthmin-1 is a potential predictor of abnormal urine Na⁺ excretion and insulin resistance for primary hypertension.","authors":"Chunyan Deng, Xiaoxin Zhou, Longlong Zhang, Qiuxiang You, Cong Liu, Yundong Zhang, Jian Yang","doi":"10.1186/s12872-025-04585-z","DOIUrl":"10.1186/s12872-025-04585-z","url":null,"abstract":"<p><strong>Background: </strong>Isthmin-1 (ISM1) plays an important role in maintaining glucose homeostasis and lipid metabolism. However, the relationship between circulating ISM1 and hypertension remains unclear. This study was aimed to investigate the association between serum ISM1 levels and blood pressure and evaluate value of circulating ISM1 for predicting abnormal Na⁺ excretion and insulin resistance.</p><p><strong>Methods: </strong>Four hundred sixty-eight individuals newly diagnosed with primary hypertension and 582 healthy individuals were initially screened. 84 participants were eligible for this case-control study. Serum ISM1 levels were assessed using ELISA. Spearman correlation analysis and partial correlation analysis were conducted to confirm the correlation. Multiple linear regression analysis was used to assess the independent association of serum ISM1 concentration with blood pressure. The receiver operating characteristic (ROC) curve was employed to evaluate the sensitivity of ISM1 in predicting abnormal Na⁺ excretion and insulin resistance in hypertensive subjects.</p><p><strong>Results: </strong>The serum ISM1 levels of hypertensive individuals were higher than that of healthy individuals. ISM1 levels were positively associated with systolic blood pressure (SBP), diastolic blood pressure (DBP) and brachial-ankle pulse wave velocity, but negatively associated with nocturnal urine Na⁺ concentration and excretion. These associations remained significant even after adjusting for age, body mass index, sex, heart rate, glucose, total cholesterol and estimated glomerular filtration rate. Multiple linear regression analysis revealed that SBP was an independent factor associated with serum ISM1 levels. The area under receiver operating characteristic curve (AUROC) for predicting low urine Na⁺ excretion and insulin resistance were 0.873 and 0.740, respectively.</p><p><strong>Conclusions: </strong>Serum ISM1 levels were positively associated with SBP and DBP. ISM1 may serve as a potential biomarker of abnormal urine Na⁺ excretion and insulin resistance in primary hypertensive individuals.</p><p><strong>Trial registration: </strong>Registered on chictr.org.cn 18/04/2024 (Registration number: ChiCTR2400083204).</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"136"},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between stress hyperglycemia ratio and contrast-induced nephropathy in ACS patients undergoing PCI: a retrospective cohort study from the MIMIC-IV database.","authors":"Yanlong Zhao, Yuanyuan Zhao, Shuai Wang, Zhenxing Fan, Yanling Wang, Fangyan Liu, Zhi Liu","doi":"10.1186/s12872-025-04573-3","DOIUrl":"10.1186/s12872-025-04573-3","url":null,"abstract":"<p><strong>Background: </strong>Contrast-induced nephropathy (CIN) is a significant complication in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The role of the stress hyperglycemia ratio (SHR) as a predictor of CIN and mortality in these patients remains unclear and warrants investigation.</p><p><strong>Objective: </strong>To assess the relationship between SHR and CIN, as well as its impact on short-term mortality in ACS patients undergoing PCI.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the MIMIC-IV database, including 552 ACS patients. SHR was calculated as the ratio of admission glucose to estimated average glucose from hemoglobin A1c. CIN was defined as a ≥ 0.5 mg/dL or ≥ 25% increase in serum creatinine within 48 h of PCI. Logistic regression and spline models were used to analyze the association between SHR and CIN, while Kaplan-Meier curves assessed 30-day mortality.</p><p><strong>Results: </strong>Higher SHR levels were independently associated with increased CIN risk (OR 2.36, 95% CI: 1.56-3.57, P < 0.0001). A J-shaped relationship was observed, with CIN risk rising sharply when SHR exceeded 1.06. SHR was also a predictor of higher 30-day mortality (P < 0.0001). Subgroup analysis revealed a stronger SHR-CIN association in non-diabetic patients.</p><p><strong>Conclusion: </strong>SHR is an independent predictor of CIN and short-term mortality in ACS patients undergoing PCI. It offers potential for risk stratification and clinical decision-making, especially in non-diabetic patients.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"135"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the clinical value of CCTA as the preferred screening method in patients with chronic coronary syndrome.","authors":"Huan Luo, Wei Zhu, Rui-Juan Fan, Li-Xiong Duan, Rui Jing","doi":"10.1186/s12872-025-04587-x","DOIUrl":"10.1186/s12872-025-04587-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The advantages and disadvantages of direct invasive coronary angiography (ICA) and coronary computed tomographic angiography (CCTA) + ICA were compared in patients with suspected chronic coronary syndrome (CCS) who presented with angina symptoms or who had nonangina chest pain with abnormal electrocardiogram results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 1200 patients who met the inclusion criteria at TEDA International Cardiovascular Hospital from January 2021 to December 2022 were randomly divided into two groups at a 1:1 ratio: the CCTA + ICA strategy (CCTA group) and the direct ICA strategy (ICA group). The baseline data were collected. All patients in the CCTA group underwent CCTA examination first. If these results showed positive obstructive coronary artery disease (CAD), then typical angina with coronary artery stenosis ranging from 50 to 70% or vascular segments could not be analysed due to severe calcification, so ICA was further performed for definitive diagnosis, and the ICA results were taken as the final diagnosis. All patients in the ICA group underwent ICA examination directly. Demographic data, cardiovascular risk factors, biochemical criteria, chest pain classification, coronary vessel lesion severity and drug use were compared between the two groups. All patients were followed for 1 year after discharge to observe major adverse cardiovascular events (MACE). The differences in unnecessary ICA rates, 1-year MACE rates, allergic reactions to contrast agents and hospitalization costs between the two groups were analysed. On the basis of the baseline clinical data of patients included in this study, a risk prediction model for obstructive CAD was established by logistic regression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;(1) There were 592 patients in the CCTA group and 594 patients in the ICA group. The percentage of unnecessary ICA procedures was 7.5% in the CCTA group and 55.2% in the ICA group (P &lt; 0.001), which was a decrease of 86.4%. (2) Eighteen patients in the CCTA group were readmitted for severe angina, 4 of whom underwent unplanned percutaneous coronary intervention (PCI). Eight patients in the ICA group were readmitted for severe angina, 2 of whom underwent unplanned PCI. There were no cardiac deaths, nonfatal myocardial infarctions or strokes in either group over the 1-year follow-up. There was no statistically significant difference in the rate of MACE-free survival between the two groups (97.0% vs. 98.7%, log-rankχ²=1.996, P = 0.158). (3) Allergic reactions to contrast agent were observed in 28 patients in the CCTA group and 16 in the ICA group (P = 0.190). (4) The median hospitalization cost in the CCTA group was $1259.54, and that in the ICA group was $1399.41, which was a significant difference (P &lt; 0.001) and a decrease of 9.99%. (5) Based on the combination of the logistic regression forward selection method and backward elimination method, variables with P &lt; 0.05, including creatini","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"130"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram to predict congestive heart failure in patients with acute kidney injury: a retrospective study based on the MIMIC-III database.","authors":"Quankuan Gu, Yucheng Qi, Yaxin Xiong, Xinyue Ma, Jun Lyu, Wei Yang, Xianglin Meng, Mingyan Zhao","doi":"10.1186/s12872-025-04569-z","DOIUrl":"10.1186/s12872-025-04569-z","url":null,"abstract":"<p><strong>Object: </strong>Objective: Acute Kidney Injury (AKI) is a renal disease marked by diminished urine output and elevated serum creatinine levels. AKI has a global incidence rate of about 20%, with an average mortality rate of 23%. Cardiovascular disease emerges as one of the primary causes of death associated with AKI. We developed a nomogram to estimate the probability of patients with AKI developing congestive heart failure.</p><p><strong>Method: </strong>We conducted a retrospective study of patients with AKI, using the MIMIC-III database. The patients were randomly divided into training and validation cohorts. Variables were selected via logistic regression, followed by the construction of the nomogram. The accuracy and sensitivity of the predictive model were verified using the Hosmer-Lemeshow test (HL) and the Area Under the Curve (AUC). The nomogram and SOFA scores were compared to APSIII using the Net Reclassification Index (NRI), Integrated Discrimination Improvement (IDI), Calibration curves, and Decision Curve Analysis (DCA).</p><p><strong>Results: </strong>The final study included 9,174 individuals. The multivariate logistic regression revealed a correlation between age, Systolic Blood Pressure (SBP), Partial Pressure of Oxygen (PO2), hemoglobin, Blood Urea Nitrogen (BUN), Chloride (Cl^-), cardiac arrhythmias, valvular heart disease, pulmonary circulation disease, chronic pulmonary disease, and diabetes. These factors are strongly associated with the development of congestive heart failure. Based on these findings, we created a nomogram. This nomogram has a higher predictive effect than the SOFA score and the APSIII score (AUC = 0.751, SOFA: 0.659, APSIII: 0.62). Its verification through NRI, IDI, and DCA demonstrated that this nomogram offers superior specificity and clinical prognosis compared to the SOFA score and APSIII score.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"133"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing cross-over stenting and focal ostial stenting for ostial left anterior descending coronary artery lesions: a systematic review and meta-analysis.","authors":"Ahmed M Khairy, Abdelrahman H Hafez, Ahmed Elshahat, Ahmed Emara, Hadeel Aboueisha, Mohamed Ismael Fahmy, Ahmed Abdelaziz, Ibrahim Yasseen","doi":"10.1186/s12872-024-04393-x","DOIUrl":"10.1186/s12872-024-04393-x","url":null,"abstract":"<p><strong>Background: </strong>The ideal revascularization approach for ostial left anterior descending coronary artery (L.A.D.) lesions continues to be a matter of debate. Two primary stenting strategies are often contemplated for managing these lesions: focal ostial stenting (F.O.S.) and the provisional strategy, alternatively termed cross-over stenting (C.O.S.) from the LM to the L.A.D. artery.</p><p><strong>Aim: </strong>Our objective is to assess the efficacy of C.O.S. vs. F.O.S. techniques in patients with ostial L.A.D. lesions who underwent percutaneous coronary intervention (P.C.I.).</p><p><strong>Methods: </strong>We systematically searched five electronic databases to identify relevant studies. The data was pooled as odds ratio (O.R.) with its 95% confidence interval (C.I.) using the DerSimonian-Laird random effect model in STATA 17 MP. Significance was determined by a p-value > 0.05 between intervention subgroups.</p><p><strong>Results: </strong>Nine articles with a total of 1492 patients were included in the meta-analysis. The pooled O.R. for Major Adverse Cardiovascular Events (MACE) was 0.88 (95% C.I. [0.39, 1.99], P = 0.76), indicating comparable rates between F.O.S. and C.O.S. For all-cause death, the O.R. was 1.46 (95% C.I. [0.53, 4.02], P = 0.46), with no significant differences between the compared techniques. Cardiovascular death showed no preference between treatments (O.R.=0.99, 95% C.I. [0.30, 3.31], P = 0.99), and similarly for myocardial infarction (O.R.=0.74, 95% C.I. [0.38, 1.44], P = 0.37).</p><p><strong>Conclusion: </strong>Our meta-analysis comparing C.O.S. and F.O.S. for L.A.D. lesions revealed similar efficacy in clinical and angiographic outcomes.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"131"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of ECG smart chest patches versus PPG smartwatches for atrial fibrillation detection: a systematic review and meta-analysis.","authors":"Olivier Sibomana, Clyde Moono Hakayuwa, Abraham Obianke, Hubert Gahire, Jildas Munyantore, Matimba Molly Chilala","doi":"10.1186/s12872-025-04582-2","DOIUrl":"10.1186/s12872-025-04582-2","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial fibrillation (AF), the most common form of cardiac arrhythmia, is associated with significant morbidity, mortality, and financial burden. Traditional diagnostic methods, such as 12-lead electrocardiograms (ECG), have limitations in detecting intermittent AF episodes. Consequently, smart wearables have been introduced to enhance continuous AF monitoring. This systematic review and meta-analysis aimed to evaluate and compare the diagnostic accuracy of ECG smart chest patches and photoplethysmography (PPG)- based smartwatches in AF detection.</p><p><strong>Methods: </strong>From august 16-20, 2024, a comprehensive search was conducted across PubMed/MEDLINE, DOAJ, AJOL, and the Cochrane Library. Original studies assessing the performance of ECG smart chest patches and PPG smartwatches in detecting AF were included. Studies were screened based on predefined inclusion and exclusion criteria, and the most relevant were finally included. For ECG smart chest patches and PPG smartwatches groups, random-effects model was used to pool these performance metrics. Statistical analyses were performed using Jamovi 2.3.28, with a significance threshold of p < 0.05.</p><p><strong>Results: </strong>A total of 15 studies were included in the current systematic review and meta-analysis. ECG smart chest patches demonstrated a pooled sensitivity of 96.1% [(95% CI: 91.3-100.8), (I² = 94.59%)], and a pooled specificity of 97.5% [(95% CI: 94.7-100.2), (I² = 79.1%)]. PPG smartwatches showed a pooled sensitivity of 97.4% [(95% CI: 96.5-98.3), (I² = 3.16%)], and a pooled specificity of 96.6% [(95% CI: 94.9-98.3), (I² = 75.94%)]. Comparatively, both ECG smart chest patches and PPG smartwatches exhibited excellent performance in atrial fibrillation detection, with PPG smartwatches showing slightly higher sensitivity and ECG chest patches exhibiting marginally greater specificity.</p><p><strong>Conclusion: </strong>Both ECG smart chest patches and PPG smartwatches are highly effective for detecting atrial fibrillation. However, further advancements are needed to match their accuracy with that of standard diagnostic methods and achieve comprehensive digital cardiac monitoring.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"132"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective discrimination of wide QRS complex tachycardia with a new algorithm - the Prelocalization Series Algorithm.","authors":"Honglin Ni, Yue Huang, Xiaowei Pan, Xiaoli Zhang, Zhiyong Wan, Changlin Zhai, Haihua Pan","doi":"10.1186/s12872-025-04583-1","DOIUrl":"10.1186/s12872-025-04583-1","url":null,"abstract":"<p><strong>Background: </strong>Electrocardiogram (ECG) plays a crucial role in the correct diagnosis of wide QRS complex tachycardia (WCT). Objective To evaluate the diagnostic value of a new WCT discrimination algorithm, herein referred to as the Prelocalization Series Algorithm.</p><p><strong>Methods: </strong>A retrospective analysis of 181 ECGs from WCT patients was conducted using the Prelocalization Series Algorithm, Brugada Series Algorithm, and Vereckei Series Algorithm. Initially, the algorithms were used to differentiate between ventricular tachycardia (VT) and supraventricular tachycardia (SVT). Subsequently, the VT cases preliminarily judged were further differentiated into VT or preexcited tachycardia (PXT). The results were compared with the clinically confirmed diagnoses to observe the diagnostic value of the three algorithms.</p><p><strong>Results: </strong>The Prelocalization Series Algorithm demonstrated higher AUC values (0.90 vs. 0.73 vs. 0.69), sensitivity (0.91 vs. 0.61 vs. 0.50), and accuracy (0.90 vs. 0.71 vs. 0.65) in diagnosing VT compared to the Brugada Series Algorithm and Vereckei Series Algorithm. The Prelocalization Algorithm's single process (without differentiating between VT and PXT) also showed higher AUC values (0.79 vs. 0.67 vs. 0.63), sensitivity (0.96 vs. 0.91 vs. 0.76), specificity (0.62 vs. 0.44 vs. 0.49), and accuracy (0.82 vs. 0.72 vs. 0.65) than the Brugada Four-Step Method and aVR lead method. The accuracy of the Prelocalization Series Algorithm in diagnosing VT (0.90 vs. 0.82) was higher than its single process algorithm.With all differences being statistically significant (all P < 0.05).</p><p><strong>Conclusion: </strong>The Prelocalization Series Algorithm is an effective new algorithm for discriminating WCT and can be attempted for diagnosing VT, SVT, and PXT.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"134"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary of the best evidence for the management of kinesiophobia in patients after cardiac surgery.","authors":"Zhi Zeng, Li Wan, Jianying Zheng, Yuqi Shen, Huaili Luo, Mei He","doi":"10.1186/s12872-025-04570-6","DOIUrl":"10.1186/s12872-025-04570-6","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to systematically search for relevant evidence on the management of kinesiophobia in patients after cardiac surgery both home and abroad. The evidence was evaluated and integrated to provide reference for clinical practice.</p><p><strong>Methods: </strong>According to the '6S' evidence pyramid model, evidence related to managing kinesiophobia in patients after cardiac surgery were systematically searched from relevant domestic and foreign guideline websites and professional association websites and databases from the date of their establishment to December 31, 2024. The quality of the literature was evaluated by two master's students who had completed their professional training and assessment at the Evidence-based Nursing Center of Fudan University. These students also extracted and summarised the pertinent evidence that met the literature quality evaluation standards.</p><p><strong>Results: </strong>Sixteen studies were included, including two guidelines, three expert consensus, six systematic reviews, two meta-analyses, and threerandomizedcontrolled trials. A total of 20 pieces of evidence were formed in seven aspects: management principles, exercise guidance, pain management, psychological intervention, health education, social support, and follow-up management.</p><p><strong>Conclusions: </strong>The comprehensive evidence summarised in this study for managing kinesiophobia in patients after cardiac surgery can provide resources for clinical translation. These insights can inform the development of kinesiophobia management plans to support the rapid recovery of patients after major surgery.</p><p><strong>Trial registration: </strong>This study was registered at the Center for Evidence-Based Nursing of Fudan University (registration number ES20245486).</p><p><strong>Clinical trial number: </strong>This study was registered at the Center for Evidence-Based Nursing of Fudan University (registration number ES20245486).This study is a summary of the best evidence and does not involve clinical trials and, therefore, no Clinical trial number.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"127"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amiodarone use and prolonged mechanical ventilation after cardiac surgery: a single-center analysis.","authors":"Xin Li, Haitao Zhang, Yuanxi Luo, Jiqing Zhu, Dongjin Wang, Li Xu","doi":"10.1186/s12872-025-04576-0","DOIUrl":"10.1186/s12872-025-04576-0","url":null,"abstract":"<p><strong>Background: </strong>Prolonged mechanical ventilation (PMV) after cardiac surgery increases the risk of complications such as pulmonary atelectasis and ventilator-associated pneumonia. This study aims to investigate the risk factors associated with delayed extubation, including the impact of cardiovascular medication.</p><p><strong>Method: </strong>This retrospective, single-center study analyzed 1,976 patients who underwent open heart surgery at Nanjing Drum Tower Hospital from October 2020 to January 2023. Patients were categorized into early extubation (n = 1071) and delayed extubation (n = 905) groups. Multivariate logistic regression was employed to identify risk factors for delayed extubation. Amiodarone were indicated to be associated with delayed extubation. To further address bias, we derived a propensity score predicting the function of Amiodarone on delayed extubation, and matched 228 cases to 684 controls with similar risk profiles.</p><p><strong>Results: </strong>Multivariate analysis confirmed that hypertension, stroke, amiodarone use, age, LVEF, CPB time, and DHCA were significant predictors of delayed extubation. Postoperative use of amiodarone was significantly associated with delayed extubation (OR:1.753, 95%CI: 1.287-2.395, P < 0.001). PSM analysis further confirmed that patients receiving amiodarone had longer ventilation times, prolonged hospital stays, and higher in-hospital mortality.</p><p><strong>Conclusion: </strong>Postoperative use of amiodarone is a significant predictor of delayed extubation, warranting careful consideration in clinical practice. Further research is needed to clarify the causal relationship between amiodarone use and extubation outcomes.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"129"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficiency of endocardial suture occlusion of the left atrial appendage at a single institution: MICs vs. sternotomy.","authors":"Chengfeng Huang, Jiawen Huang, Si Shen, Yongheng Li, Yanlin Zhang, Xiaoshen Zhang, Hua Lu","doi":"10.1186/s12872-025-04540-y","DOIUrl":"10.1186/s12872-025-04540-y","url":null,"abstract":"<p><strong>Background: </strong>Most thrombi originate from the left atrial appendage (LAA), preventing thromboembolic stroke is an important aspect of stroke prevention. Previous studies have found that LAA closure is beneficial for preventing thrombosis. Currently, surgical procedures can achieve LAA closure by closing the endocardium or epicardium. LAA endocardial suture technique is performed concomitantly during sternotomy cardiac surgery but can also be performed during right minimally invasive cardiac surgery (MICS).</p><p><strong>Aims: </strong>This study aims to evaluate the efficacy of left atrial appendage closure (LAAC) with MICS.</p><p><strong>Methods: </strong>A total number of 74 patients who underwent LAAC during valve operation between 2017 and 2021 were retrospectively analyzed in this study. LAA was closed by continuous suture through the endocardium of the left atrium during cardiac surgery. 42 patients performed LAA endocardial suture during MICS, while 32 patients performed with the same LAAC technique during sternotomy. Patients underwent cardiac computed tomography (CT) follow-up after surgery to verify the completeness of the LAAC. The heart structure and function were recorded by echocardiography Transthoracic echocardiography (TTE), and the heart rhythm was recorded by electrocardiogram.</p><p><strong>Results: </strong>The LAA closure procedure was successful in 26 cases (81%) in the sternotomy group and 20 cases (48%) in the right minimally invasive group. Residual shunting (failed LAA closure) was more common in the right minimally invasive group (p = 0.003), and no correlation was found between residual shunting and left atrial (LA), left ventricular end-diastolic diameter (LVDD), and left ventricular ejection fraction (LVEF). The incidence of leaks was not associated with mitral valve replacement or valvuloplasty.</p><p><strong>Conclusions: </strong>Compared to sternotomy, residual shunting after MICS was more common. CT imaging analysis of 22 patients with failed closure in the MICS group showed that residual shunting was mainly concentrated on margins of the suture (anterior superior and posterior inferior) (86%), with a middle area accounting for 3 (14%). Based on this finding, reinforcing the suture margins may significantly reduce the incidence of incomplete closure.</p><p><strong>The clinical trial number: </strong>KY-2023-001.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"128"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}